Schizotypal Personality Disorder

Is oddness a personality disorder? Most of us are a little odd at time. Perhaps, on occasion, a little quirkier than others. Oddness, by itself, is not a personality disorder, just a testimony to our beautiful individuality. However, oddness could be related to schizotypal personality disorder. When extreme personality peculiarity cooccur with social and interpersonal deficits, perceptual disturbances, magical thinking, and eccentric behavior may indicate the presence of the schizotypal disorder. Others often describe Individuals suffering from the this personality disorder as eccentric or bizarre.

The social oddness most likely corresponds with the schizotypal person’s difficulty with interpreting social cues. These interpersonal deficits limit the capacity of those diagnosed with this disorder to enjoy close relationships.

Common Symptoms of Schizotypal Personality Disorder

Common symptoms or this disorder includes:

• Suspiciousness or paranoia
• The belief of possession of special powers or talents (mind reading, clairvoyance, séance, etc…)
• An obsessive focus on religious, occult or superstitions
• Strange patterns of speech and unusual word usage
• Excessive social anxiety
• Often dressing oddly ways, wearing strange costumes or hats, a jacket in hot weather, or lack of cleanliness
• Problems forming or maintaining relationships outside of immediate family
• Limited emotional responses. emotionally disconnected

DSM Classification of Personality Disorders

Schizotypal Personality Disorder was originally introduced in DSM-III, derived from two converging lines of investigation:

• Borderline Personality conditions of functionally impaired patients manifesting a variety or pervasive disturbances of:
  • Interpersonal function
  • cognition
  • affect
  • behavioral control

• Studies of non-psychotic family members of patients with schizophrenia where the family members exhibited peculiarities of thought and speech (Rosell et al., 2014)

The DSM-IV-TR divides the ten recognized personality disorders into three clusters. The schizotypal disorder is a cluster ‘A’ personality disorders. Personality disorders in this cluster have traits centered around unhealthy “suspicion.” All three disorders (paranoid, schizoid, schizotypal) in cluster ‘A’ are include traits found in the schizophrenia spectrum. This cluster describes personalities with odd and eccentric behaviors.

Five of the nine DSM specified criteria are required for diagnosis:

1. ideas of reference
2. odd beliefs or magical thinking
3. unusual perceptual experiences and bodily illusions
4. odd thinking and speech
5. suspicious or paranoid ideation
6. inappropriate or constricted affect
7. behavior or appearance that is odd, eccentric, r peculiar
8. lack of close friends or confidants (other than first degree relatives)
9. excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears

 Schizophrenia Spectrum

There are five subtypes of schizophrenia (Catatonic schizophrenia, Disorganized schizophrenia, hebephrenic schizophrenia, paranoid schizophrenia, Residual schizophrenia, and Undifferentiated schizophrenia​). The subtype is based on the primary symptoms. However, a client’s subtype changes over time. Therefore, mental health professionals typically choose to classify patients with the broader categories listed as schizophrenia spectrum disorders instead of by a changing subtype.

Schizotypal personality disorder is included in the schizophrenia spectrum. There are three schizophrenia spectrum disorders:

• schizophrenia,
• schizoaffective disorder,
• delusional disorder,
• schizotypal personality disorder,
• schizophreniform disorder,
• brief psychotic disorder,
• psychosis associated with substance use or medical conditions

Schizoaffective disorder is similar to schizophrenia but with major episodes of shifting moods such as major depressive disorder or bipolar disorder. Schizophreniform disorder is identical to schizophrenia but with a shorter duration of symptoms, typically longer than a month but shorter than six months.

Schizotypal personality disorder is similar to schizophrenia, but the schizophrenic episodes are not as frequent, prolonged or intense. Individuals with this disorder can usually be shown that their distorted ideas and experiences are not reality. Patients with this disorder “are spared the chronic psychosis of schizophrenia” (Kirrane & Siever, 2000).

​Schizotypal Personality Disorder Causes and Risk Factors

No single factor cause Schizotypal personality disorder. Studies have identified a genetic link. However, possessing the genetics only create a vulnerability to the disease and not an inevitability.

A couple psychological concepts and lines of theory and study can help us better understand illness vulnerability versus inevitability. Epigenetics is a new topic of research in genetics.

In epigenetic studies, researchers examine the environmental impact on gene expression. Science has discovered that “our DNA sequences do not unbudgingly create who we are. A gene is subject to external influences that may activate gene expression” (Murphy, 2021). A person may inherit the genetic makeup attributed to ​schizotypal personality disorder, however, their environment may not lead to the gene expression of the disease.

Another model that provides insight into disease expression is the diathesis stress model. In the diathesis stress model it is “hypothesizes that psychological disorders develop as a result of interactions between pre-dispositional vulnerabilities (the diathesis), and stress from life experiences” (Murphy, 2021).

Several studies have found an associative link between schizotypal personality disorder and psychological trauma (Berenbaum et al., 2008). 

 Treatment for  ​​ Schizotypal Personality Disorder

Because of the strong underlying genetic causes, ​schizotypal personality disorder is not considered a curable disease. However, the illness can be treated by addressing the individual symptoms. Both medication and therapy has been shown to help patients manage moods and improve functionality.

References:

Berenbaum, H., Thompson, R., Milanak, M., Boden, M., & Bredemeier, K. (2008). Psychological Trauma and Schizotypal Personality Disorder. Journal of Abnormal Psychology, 117(3), 502-519.

Kirrane, R., & Siever, L. (2000). New perspectives on schizotypal personality disorder. Current Psychiatry Reports, 2(1), 62-66.

Murphy, T. Franklin (2021). Epigenetics. Psychology Fanatic. Published 11-9-2021. Accessed 5-17-2022.

​Murphy, T. Franklin (2021) Diathesis Stress Model. Psychology Fanatic. Published 9-7-2021. Accessed 5-17-2022.

Rosell, D., Futterman, S., McMaster, A., & Siever, L. (2014). Schizotypal Personality Disorder: A Current Review. Current Psychiatry Reports,16(7), 1-12.

Rosenfarb, I.S., Juan, M.A. (2006). Schizotypal Personality Disorder. In: Fisher, J.E., O’Donohue, W.T. (eds) Practitioner’s Guide to Evidence-Based Psychotherapy. Springer, Boston, MA . 

Siever, L., Chemerinski, E., Triebwasser, J., & Roussos, P. (2013). Schizotypal Personality Disorder. Journal of Personality Disorders, 27(5), 652-679.

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